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ADHD & Puberty

Instructor: Jocelyn Cherry

Jocelyn has taught Special Education for over two decades and has three post secondary degrees all in the field of Education.

Changes during puberty combined with ADHD symptoms may make this awkward time even more difficult for children with ADHD. This lesson will examine some differences between how children with ADHD and their non-ADHD peers experience puberty.

Issues for Children with ADHD during Puberty

Puberty is stressful for all children experiencing it, not to mention those around them. Puberty brings physical, psychological, and social changes over an extended period of time as a child matures into adulthood.

For a child diagnosed with Attention Deficit Hyperactivity Disorder (ADHD), puberty is no more traumatic or problematic than for a peer without ADHD. However, different issues may surface that educators and others should be aware of to reduce stress. Proactive measures and careful observation during this time can help make the process smoother.

Consider these differences between puberty for a child with ADHD and for a non-ADHD child:

  • Maturity
  • Medication
  • Hormonal effects on girls
  • Development of boys

Educators need to be aware of how puberty affects their students' behavior and academic performance, but they also must observe their professional responsibilities.

Maturity

The emotional maturity of children with ADHD experiencing puberty can vary. Children with ADHD can be 20-30% less mature than their non-ADHD peers. The physical body changes can be hard for the child with ADHD to comprehend, and social skills and cues may be harder to master. While non-ADHD children contemplate dating and show interest in the opposite sex, an ADHD pubescent child may not be at the maturity level to show the same interest.

Medication

Most children on medication for ADHD do not require a change of medication, even with significant weight gain or loss. The problem becomes the refusal to be medicated. Teens want to fit in and be as similar to their peer group as possible. They do not want to be singled out for a medication trip to the clinic or school nurse, especially before or after lunch. At the elementary level, students cooperate with medication requests, but this can suddenly shift in the middle and upper grades. If they recognize the side effects of certain medications, students may begin to rebel and refuse to medicate rather than ingest medicine that may curb their appetite or make them less social.

If a child is reluctant to take medication during the school day, parents or guardians may choose to consult with their child's physician about extended release medications that last up to 12 hours, as well as other medications, for which trials are in progress, that may last as long as 18-24 hours. Fortunately, medication issues may disappear for many children as they mature, because approximately half of children with ADHD improve dramatically after puberty and no longer require medication.

Hormonal Effects on ADHD Girls

The 'raging hormones' that girls exhibit have profound effects on girls with ADHD. Girls typically start puberty between ages 9 and 11 and have their first menstrual cycle between ages 11 and 14. Pubescent girls with ADHD tend to have more academic difficulty, struggle suddenly in certain areas, and can be more forgetful with their homework or assignments. These changes may be related in part to fluctuating levels of estrogen and progesterone. During a menstrual cycle, estrogen levels are higher during the first two weeks and then lower with rising progesterone levels during the last two weeks. Low estrogen levels can be correlated to forgetfulness and cognitive difficulties. For some girls with ADHD, medications may not be as effective during the last two weeks of their menstrual cycle.

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